Have you ever wondered about the complexities and nuances of human sexuality? Well, you're not alone. Join me as I sit down with Angela Nauss as we unpack some of these very intricate issues. We tackle the controversial topic of sex addiction - its disputed recognition, the delicate balance of diagnosing sexual dysfunction, and the journey to make it an officially accepted clinical term.
Kink, a realm often filled with misconceptions and mystery, is another area we explore with Angela. Learn the importance of consent, respect for boundaries, and effective communication in the world of kink. Hear me share a personal experience that underscores the importance of these elements. We also dive into the historical context of homosexuality and sexual deviancy, discussing the implications of tagging certain sexual activities as mental disorders.
More about Angela Nauss, LMFT
More about James Marrugo, LPC:
https://morningcoffeecounseling.com/
If there are questions you want answered or topics you want me to cover, send me an email at
James.Marrugo@MorningCoffeeCounseling.com
Music by AlexGrohl from Pixabay
Have you ever wondered about the complexities and nuances of human sexuality? Well, you're not alone. Join me as I sit down with Angela Nauss as we unpack some of these very intricate issues. We tackle the controversial topic of sex addiction - its disputed recognition, the delicate balance of diagnosing sexual dysfunction, and the journey to make it an officially accepted clinical term.
Kink, a realm often filled with misconceptions and mystery, is another area we explore with Angela. Learn the importance of consent, respect for boundaries, and effective communication in the world of kink. Hear me share a personal experience that underscores the importance of these elements. We also dive into the historical context of homosexuality and sexual deviancy, discussing the implications of tagging certain sexual activities as mental disorders.
More about Angela Nauss, LMFT
More about James Marrugo, LPC:
https://morningcoffeecounseling.com/
If there are questions you want answered or topics you want me to cover, send me an email at
James.Marrugo@MorningCoffeeCounseling.com
Music by AlexGrohl from Pixabay
Hello and welcome to another episode of the Mental Health, without the Bullshit. For this episode I have something special lined up with a returning guest. But before we get into the content of talking about sex therapy, kink and sex addiction and various other topics, let's introduce our guest, angela. Let the people hear your voice.
Speaker 2:Hi, I'm Angela Knoss. I'm licensed in California. In Colorado, I'm the author of several articles about PTSD and trauma, because that's my area of specialty and I know almost nothing about sex therapy.
Speaker 1:Awesome. Thank you for that. So, listeners, angela was on a previous episode relating to her specialty in trauma you can find that in the backlog of my uploads but after the recording, she had posed an idea to me to talk to me about one of the things I'm passionate about, which is sex therapy, sex positivity and everything in that general area. She wanted to actually interview me on my own podcast, which I thought what a wonderful idea. To be interviewed about something I really give a shit about, which is the whole point of my podcast, is to just find other therapists who are really passionate, let them speak through their passion and to help the average listener just understand their mental health and potentially find a therapist. So, angela, you had emailed me a list of things to talk about and questions that you've discovered from people around you and your own clients as well, as far as things within sex therapy. Let's let it rip. Where do you want to start?
Speaker 2:So I've divided these questions into different categories. The first one is sex addiction, then we'll talk about kink, then LGBT stuff and then marriage and finally, if we have time, we'll talk about finding a sex therapist. How does that sound?
Speaker 1:That sounds wonderful. I am so excited to be interviewed by you and talk about something I'm so passionate about. What's the first question? Let's get this thing going.
Speaker 2:All right. So for listeners who might not know, many therapists have to diagnose using diagnosis codes. We use the DSM-5 in this country. If your therapist doesn't diagnose, that's fine, you don't have to, but a lot of insurance panels require it. Sex addiction, fun fact, is not in the DSM-5. This is a sticking point for a lot of therapists who would like to diagnose clients with sex addiction because they believe it's real and it's a real thing. A lot of clients believe it's real and they come to therapy for this kind of treatment. I'm curious does sex addiction exist in other countries or in the ICD-10, which is like the international diagnosis list?
Speaker 1:Yeah, so this is such an interesting thing. So the very first client I ever had as a therapist, and what I mean by this. I was still in school and being heavily supervised by my professors and supervisors. I was in a room with a one-way mirror and everything was recorded. As it is for a lot of students, particularly from Regis University, that's all of us learned. And the first client I ever had showed up and told me he's a sex addict. So the first ever public client I had diagnosed myself with sex addiction.
Speaker 2:I was coming in real hot.
Speaker 1:Real hot, real hot, yeah, absolutely so. This was years ago. It's been almost four years since this occurred, and I was so fucking unprepared for that statement from him because when I asked him what brings you to counseling which is a very standard and basic question all of us ask just to get the conversation going His response was I'm a sex addict and I need help, and I'm thinking what the fuck? There's no training for this. This is not in the DSM.
Speaker 2:There is no training.
Speaker 1:None.
Speaker 2:Well, there is training. You talk about that, sure.
Speaker 1:There is no.
Speaker 2:One of the most controversial diagnoses not in the DSM, correct, and that's your first case.
Speaker 1:First case, right out of the gate, tells me he's a sex addict and he wants help, wants to do better. So that's all great. We go through our first appointment, you know going over very basic stuff, like all therapists do, and I'm still technically a student right, I'm a student seeing people from the public for free. This is how we learn in counseling school. After the session I go open the DSM and look for sex addiction and then I realize there's no such thing here. This is not a diagnosable thing to treat in the United States. My second response was to go look at the ICD 10. And same thing that there's not an actual.
Speaker 1:The term sex addiction is not clinically relevant anywhere. People treat it, people get help for it. There's books written about it, there's seminars, there's so much content about sex addiction, but you can't actually be clinically diagnosed as a sex addict. The term that we use is sexual dysfunction, which is very vague and could mean a lot of things. Anything can be dysfunctional in sex. It could be like not being able to maintain an erection right, erectile dysfunction and all those things. Or it could just be like a trauma response that stops you from climaxing is a sexual dysfunction. So the term sexual dysfunction is a term that is used to diagnose sex addiction, to get that covered through health insurance, to get sessions going, but it's not an actual clinical term technically because it's not recognized anywhere. If anyone needs a sex addiction diagnosis, you're going to be diagnosed with a sexual dysfunction. We're going to have to put like specifiers in there, which is a more, sometimes a more concrete description of specifically what is just what type of sexual dysfunction is this person dealing with, because that's a vague term that doesn't really mean anything to anyone, but that is the term that we use.
Speaker 1:So in short, to answer, does sex addiction exist outside of the DSM? So far no, and I have personally looked into why that is the case and the American Psychiatric Association, which is one of the governing bodies of mental health. They haven't really given a clear cut reason as to why and I think there is a recent hearing to try to add sex addiction as an actual clinical term to the DSM five. I think it happened three, four years ago, I can't remember the exact date. It got denied heavily. Basically was when you, should anyone care enough to Google this information, look into it. The general consensus is the board, the panel of people who make these decisions came together almost unanimously said no, we're not adding sex.
Speaker 2:When you and your sex therapy friends, because I know that therapists and niches hang out together or when you talk to therapists in general in your life, which is a thing you do, what do they think? What's the word on the street? Do therapists want this?
Speaker 1:Yeah, I mean particularly if you do work counseling, a therapy in the area of sex in general, right, regardless of any subcategories. The general consensus is from the public of therapists. We do want that term because it doesn't make sense that it doesn't exist. Right, there are licensed addiction counselors and licensed addiction trainings and addiction is a clinical term. There's several addictions in our DSM and in the ICD-10, things that we use for health insurance panels for diagnosing and treatment planning and all that stuff for reimbursement, like there's money in this. All the other addictions most of them are there. But sex addiction, which is a thing people deal with, it's not that uncommon, is not technically can be diagnosed as a sex addict, even though we have groups for this. Right, we have AA. Alcohol is Anonymous. Right, we have NA for narcotics. We also have SA meetings for sexual addiction that function just like AA meetings and everything else. I've had clients go to those meetings for sex addiction and it functions very well to AA and all the other types of support groups. So in general, we want that, which is why we keep pushing for it. It's not that Pushing for the term sex addiction is not recent. We've been pushing this for years because it's been a problem for Select individuals for decades. I mean we like for as long as we've had addiction in humanity, we've probably have had sex addicts, so that's. This means that we've been trying to help people with sexual addiction for a very long time.
Speaker 1:And and Pornography, you know it's, it's promoting that type of addictive behavior because it's easily accessible. It's showing things that are Not always within the norm or it's too easily accessible. Addicts in that area tend to struggle there or people become addicted being exposed at a young age. Same with alcohols. Reason why we don't let people drink below certain age. It's easier for them to get addicted. It's bad for their general development. Pornography which I know making it sound like porn is bad, which I don't think porn is bad, but it is. I treat it as a substance that needs control, same as anything else. We don't let people blow the age of 21 drink for a reason. Same why, you know, we we try to regulate and limit access to prescription medication, all these other things. These substances can change the Person's wiring in the brain, how they respond to dope, mean and all these other narrow transmitters. Porn does the same thing. It can turn into a substance that is abused.
Speaker 2:Let me ask you something. So if sex addiction isn't a thing, what's this whole buzz about deviant sexual interest? I've heard that as a term used by other therapists. What is the line for deviant sexual interest? What does that mean? Is that like kink?
Speaker 1:Yeah, I love this topic and I love that you you're bringing us up Deviant. So I I personally don't give a shit for that term when it comes to like sex therapy, because Deviant means something is outside of the norm, right, and it has a negative connotation to it which I also don't agree with, which is why I personally don't use the term Deviant or deviancy or anything like that, because it makes people feel awkward. It doesn't allow space to normalize whatever it is they're going through. So if we look at the term, deviant is basically anything that strays from mainstream. So technically speaking, if you have a kink or a fetish or you don't fit the heterosexual norm, you're officially a deviant. Now, a lot of negative that connotation comes with that. But basically to answer your question, what is the line between Someone who has deviant sexual interest or not? In the general term, anything that's not mainstream relationship styles is deviant.
Speaker 1:Now, with therapists, I've heard different definitions. Me being a sex therapist, I think I have a lot more tolerance for people's sexual behaviors and what I think is is healthy or is not healthy. So to any particular therapist, probably what I've heard from my own exposure Deviant sexual interests or deviant sexual behavior is when things are outside of that therapist's realm of normalcy. So I've had some therapists tell me that they they have a client who's trying to explore or polyamory and that's deviant because it's causing a rift in their relationship. I don't see it that way. I see is this person might be living in incongruent lifestyle which is causing mental health issues.
Speaker 2:Okay, so then what does kink informed mean?
Speaker 1:Yeah. So we have a lot of these terms with like kink and poly and consensual Non-monogamy or ethical non-monogamy there's so much terminology when it comes to sex therapy. But when someone is informed, that means they, they have awareness of it, they have some level of education or training into a particular area when it comes to sex therapy or section general. So the term that I use personally is sex positive. That is an umbrella term. It means I'm open to all of it, I have training and plenty of it, and None of that stuff is off the table as far as Clinical relevance or topics of conversation within sessions with me.
Speaker 1:Someone could say they're kink informed, they're kink friendly, they're kink allied. Informed and allied are almost the same thing. Friendly means that they're open to talk about it, but that does not mean that they're informed or well-trained in it and so their level of understanding or Level of acceptance might be questionable for the client. But basically, sex positive is the umbrella term that I whatever it is you got going on in your life I'm safe to talk to and I have enough experience and education and training and knowledge in it that I'm not gonna ruin your life with the next thing out of my mouth.
Speaker 2:All right, james, I'm gonna push you a little bit.
Speaker 1:Let's do it.
Speaker 2:I want to know, tell me, how kink can be unsafe 100%.
Speaker 1:This is such a lovely topic because when people's first start exploring kink if they're, you know, not currently involved in kink In any capacity one of the first things clients bring up to me is safety concerns. And what I say is kink can be unsafe when there's a lack of boundaries, a lack of of ruling and a lack of consent. So, first and foremost, can consent. If there's no consent, it's automatically unsafe because something is happening to someone, or at least within their perception, that is unwanted, unwarranted and no one likes that. This whole reason why consent is so important when it comes to anything sexual if there's no consent, it's, it's not healthy, it's not helpful and at worst, it's traumatizing and possibly illegal.
Speaker 1:So unsafe kink for me is when people don't respect each other's boundaries, don't allow space for informed consent and don't have, you know, rules and guidelines for when it is time to stop or when there's a threshold gets pushed too far. You need some type of structure around it, which I know it makes it sound like it's Regimented and scheduled. Isn't a half to be, but you still need to respect that there's another human being Involved, even if it's just you doing it, something within yourself. You also have to respect your own boundaries. Pain is fine and pain can be pleasurable, but there's also a point of pain that is not physically okay. You don't need broken bones to be kinky, that's that's just risking permanent damage. So to me, unsafe kink is lack of boundaries, lack of consent and just a lack of any kind of structure around it.
Speaker 2:Yeah, unfortunately I run into this a lot in my own practice. You can imagine people who come to see a trauma therapist haven't had a great time with kink. How do you keep it safe?
Speaker 1:Talk about it. That's one of the first things I talk with my clients about it. Anything relating to sex Communication, especially if you're getting into like kink, fetishes or anything in that area, right, that you're unfamiliar with or you're just within a new partner, a new relationship with, communicate. It's the same as trying to function in a marriage. If you don't talk to the other people in the room, how do you know what's going on in their head, what are their boundaries, what are their limitations with their needs or wants, what makes them feel safe, what makes them feel unsafe? Right, you have to communicate.
Speaker 1:So if you're thinking of getting involved into kinky behavior, talk about it first. Talk about it Playfully, explore it. If you've already had the conversation, do something on the lighter end. Don't die full into it. There's, you might get overwhelmed and you don't always know what's happening. I've had several clients Want to get into kink and, you know, find a sex dungeon is what they call it. They'll go, you know, and there's a lot of people in the room, a lot of shits happening. They've never been there before but everyone else is already pre-established and you know, one thing turns into another and they end up with sexual trauma. That happens. It's slow down, talk and talk, and talk until you feel safe and Comfortable and then take the next step and do so slowly, and then repeat that process until you reach a point of satisfaction.
Speaker 2:Now I like that idea start slow, maybe by yourself, maybe talk to some people who are into this, get their feedback 100%.
Speaker 1:I. I will always tell people, regardless of what is going on in their life. You got to communicate in order to keep yourself safe, to establish boundaries, to find someone else's boundaries. Otherwise, you're just assuming they're gonna read your mind and know what to do or what not to do, and we all know that's not how this works.
Speaker 2:For sure, right I Mean maybe a good first step might be, like you know, reaching out to some online communities or going to a shop where they have this kind of Stuff. Find out what the rules are, what the stuff is 100%.
Speaker 1:When clients are trying to explore a particular type of kink. You know I I say listen to your body. Right, if you're thinking of getting into, you know leather whips, that's great Good for you, right, fast you, you think that might be your thing, go to a store where they sell those things and just go look at a, pull them, touch them, see how you respond. Is it fear, is it excitement? It like how are you responding? And listen to that response before you start buying all these whips and using it. It might not be what you think it is.
Speaker 2:Can I tell you my sex shop story with my husband?
Speaker 1:Absolutely.
Speaker 2:So I am like a one of these people but I don't do sex therapy and I brought him to the store back when we lived in LA because I needed we were, I was buying some, I was making a purchase that doesn't need to be discussed on this show, it doesn't matter and I brought my husband with me. He's like imagine a giant child. I'm married to him, I love him more than anything, but he needs to touch things and this is not the store for that. You know, usually you go to the grocery store. He'll like touch all the produce, that's fine. You go to the the dungeon store in LA. You know, imagine this man going in, this giant child, and he needs to touch everything in the dungeon store. So they have this item Um, use your imagination on display and the item has buttons on it and I'm looking at something else.
Speaker 2:I'm not paying attention, but I passed the item with buttons and I'm like he better, not, that's all I thought and I like, moved on, I had a mission right. He, without me looking because I wasn't supervising him. All of a sudden I hear, like this commotion on the other side of the store because he's pressed the buttons and this item has started to move Like that's. That's what it's there for. It's a demonstration item like. Please try and imagine First of all what this item was suddenly started moving. Use your imagination and then imagine the look on this man's face he's wearing. He's like the most vanilla person in the world. He has like a bass pro shops hat on, standing next to this item that is now moving on a table that everyone knows he's pressed.
Speaker 1:I love that. I Love that. I like that approach to the open-mindedness exploration. Yeah, go to the stores, look at this stuff, see how you feel about it. See you think about it. If you can, if it's allowed and appropriate, touch it. See how your body responds to having more interaction with it.
Speaker 2:Oh, also a note I think I'm not sure if everyone knows this, but I think there are some stores where people are more chill than other places, so I obviously can't vouch for like every sex shop in the world, but I've been to some places where the employees are like really nice. They're like you can ask me anything, and you can literally ask them anything, Things that you cannot ask employees in other shops. They will answer your questions 100%.
Speaker 1:Yeah, some of the sex shops, the people who work there, are really open and friendly and engaging and want to provide a service. They want to help. They know a lot of people are interested in these things and are just inexperienced and don't know. And you know, if you can find that, grab onto those people, ask them questions, get to know them, talk about things that's going on in your mind and gain from that knowledge and experience. It goes back to just we got to communicate in this area because otherwise you're just trying to run off of you know, telepathy and hoping you can read someone's mind, and that often just does not work. It'll usually cause more problems than it solves.
Speaker 2:I love that quote. You cannot count on other people to read your mind.
Speaker 1:I always say that to my clients when they're having relationship issues or, you know, unhealthy interactions. That's just causing a lot of pain and suffering. There's a need to happen to someone else and that's why I tell them you can't count on them to read your mind. You better leave and know what's going on in your own head. Half the time there's a lot going on in our minds. We're always distracted, always doing something, always moving. It's hard to slow ourselves down enough to really examine what we're dealing with. What do you think someone else is going to just slow down and hone in on you alone when they also have their own personal shit happening? You can't count on that. It's not a reliable way to build healthy relationships. It's better to just say things out, right, or if you can't, then you know listen to that. Listen to that. You can't even communicate with this person. Why does an indicator in and of itself that maybe this is not the person you need to really bother with, then? If you can't talk to them, then what's the point?
Speaker 2:Excellent question, ask yourself should I be doing this if I can't tell this person? No, if I wanted to.
Speaker 1:Bingo yeah, I love that and I clients have brought that up to me, you know as well as their partners, interested in something that is just outside of the comfort zone and despite their best efforts, they're just not. They're convinced they're not going to get there To come to me. You're like, well, how can I get there? And I'm thinking like, no, listen to your body If this is that far out of your comfort zone, right, and you've had tried to get there to see if it's something you could be comfortable with and it's just still not happening. There's no therapy to get there. You're asking me to traumatize you. That's the exact opposite of what I want from this whole interaction. It's listen to that and I start exploring how come your partner has to?
Speaker 1:How do you respond when they push on these topics or push on this type of interaction with you? What is the individual response? How do you assert yourself? How do you set boundaries? Do you communicate any of this stuff? Is this person respecting you, saying no? Because if they refuse to respect you, saying no, that's inherently not safe, right? You're literally telling them I do not give you consent, that saying no is removing consent from the situation. So then, anything past that is now becoming unsafe.
Speaker 2:Okay, let me ask you something I'm confused about. So there's a lot of kinks listed in the DSM and if they're in the DSM it's a mental disorder. Tell me what you think about that. Does that mean I have a mental disorder from one of those kinks?
Speaker 1:No, that's something people within sex therapy have argued on and off about, and it comes down to it out of control sexual behavior is a term that we use in this area of counseling, and it's basically someone who's lost control of their own behavior, similar to an addict, who just cannot contain themselves and will do whatever they need to do to get their fix again. So out of control sexual behavior is more looked at like an addiction right, and again, we don't have the term sex addiction to use for any of this. So this comes back to old, old ways of thinking. As far as you know people, having sexual deviancy, having a kink, does not mean you have a mental health issue. It becomes an issue when you can't function on a normal basis without it.
Speaker 1:So very basic things like feeding yourself, taking care of yourself, hygiene, you know, paying your bills, going to work those are all basic. You know everyday things and whenever something about your life starts interrupting that, there's issues. Something needs to change, something needs to be addressed, something you need to talk to somebody who has expertise and things you don't in order to find a solution to it. So having a kink does not mean you have a mental health issue, a mental health disorder, but if you could say I can't function without it. You know, engaging in this kink is interrupting you know who I am at work and how I am with my friends and I'm losing a sense of a normal quality of life. Yeah, then you're. You're having problems, but the fact that you have a kink does not make it an issue. You are, you have a kink. Lots of people do. We just don't talk about it enough.
Speaker 2:Okay, well, here's the thing. Give me, like the history of this, because I know that homosexuality used to be in DSM like until recently, disturbingly recently. Give me the whole background on that situation.
Speaker 1:Yeah, yeah, so I have looked into this. I wouldn't say I'm an expert in understanding everything that happened, but basically we are currently on DSM five, so that's the fifth edition of our diagnosis dictionary. Book is what therapists use, right? This thing got officially removed in number three and that happened in the early 70s, I think like 1972 1973 is when it was removed, but it was first put in and I think like the early 50s, 51, 52, maybe and it was DSM one.
Speaker 1:So the first time anyone had put together a basically a dictionary of mental health disorders was the DSM one and in there was homosexuality as a mental disorder and it was termed sociopathic personality disturbance and that was an umbrella term for all kinds of things relating to sex and some other like basically what we now call today personality disorders. So effectively, back then in the early 50s, after the DSM came out, if you were found to be a homosexual, you basically had a personality disorder and a severe mental health diagnosis that needed, you know, intensity for your treatment. Along with that came a host of really horrible treatments for homosexuality and we were electrocuting people for a long time. And that's the little thing. Apparently, today I've heard reports of other therapists finding out someone who is a therapist still engaging in this very unsafe type of treatment, basically just electrocuting you for getting an erection as a gay man. Anytime you look at you know gay pornography or an attractive guy, you get a little bit arousal, you just you get electrocuted. That's literally what's happened. It called it like shock therapy. It's important and not a thing anymore. And it took up until the early 70s to get rid of homosexuality being a mental diagnosis. So if you think of when it came out and where we are now, it's not that big of a gap. So they're basically for a while people therapists have built an entire career of treating homosexuals in the community in various capacities men and women and part of the sociopathic personality disturbance also came down to like pedophilia, trans and pretty much the entire. If you now fit in the LGBTQ plus community in any capacity and if you in any way have a kink or fetish, back in the 50s, yeah, that was sociopathic personality disturbance, umbrella diagnosis and you had to have treatment for that and it took up until the early 70s to get that out in the DSM three and we're only in the DSM five. So we're still working on that. We're still struggling to get that ideology in those terms more appropriate.
Speaker 1:Hence the recent push to have sex addiction as an actual term to use, because it's a sexual dysfunction, as in lieu of sex addiction. Sexual dysfunction means a lot of things. It doesn't always mean that this person is struggling with any type of addiction, and a lot of sexual dysfunctions aren't deviant. It could just be like there's a problem of some kind. I've had clients who've had trauma through sex not be able to engage in any kind of sex. That's a that's termed as a sexual dysfunction. You could also diagnose it as trauma, which is what I typically do, because that's what more going on. But I could also use a sexual dysfunction diagnosis, and that's the problem with that term. It's too broad. It means almost nothing.
Speaker 2:I want to ask you some LGBT questions. Yeah, all right, these are crowdsourced. First one what if I've been married for years and now I have thoughts about the opposite sex? Should I get an instant divorce? Is this normal?
Speaker 1:This is normal. This does happen. No, you don't need an immediate divorce, first and foremost when you find yourself being attracted to the opposite sex and you weren't for a long time. Our society, particularly in America, we're really bad about this, but we gear people through our culture and social norms to to be heterosexual. So there's a really good chance that you're suppressing a lot of natural reactions within yourself and finally it's gone to a point where your body just can't take the bullshit and the lies anymore. And this occurs not just within same sex or not, but it could also be with, like kink or poly or a lot of other areas in which that's just who you really are. It's just been suppressed your entire life and your body is just now not having it. It's just coming out.
Speaker 1:The thing I would say to do right if this is you Explore that. You don't have to immediately bring it up to your partner. That depends on how safe do you feel with that conversation? Some clients I've worked with did they notice this and they felt safe enough in their relationship safe with the person they're being vulnerable with to bring this up. And others say I can't bring this up because it's not going to go well, we'll trust that and that's completely okay. It's your own personal life. You're allowed to have privacy. First explore that and if you feel like it might go somewhere, think about talking to someone you trust your partner, an extremely close friend. My bias, obviously, is find a mental professional to help you navigate and explore coping and processing and all that stuff which is going to be pretty heavy. But you don't need an immediate divorce just because of that.
Speaker 2:Okay, this next one, I think, is like every therapist I've ever talked to. You hear this one a lot and, matt, I will speak from the perspective of a client coming in with this. I want to have a threesome with my husband. I have heard about Polly but done zero research. Is this a good idea?
Speaker 1:Yeah, I've worked with a couple of people who've kind of taken that approach as well. Coming to the counseling Is Polly a good idea? It is if that's who you really are and that's what you really want. So poly polyamory right, Polly, meaning multiple and amory the term of love. So polyamory is different in terms of ethical non-monogamy or consensual non-monogamy. So polyamory means like having multiple intimate partners. It's not just the physical aspect of sex, it is emotional attachment. So having a threesome and saying poly inherently does not make sense, because if you just want to have a threesome, you can. You don't need a high level of emotional intimacy with that. That's not a need. Is this a good idea? That depends on the relationship. Right, Again, it comes back to consent and communication.
Speaker 1:If one partner wants to have a threesome, the other doesn't Talk about it. Don't try to push your agenda onto your partner. They have a right to feel safe and secure in their relationship. And if you can't be happy in a relationship without having a threesome, if that's an absolute limiter for you, that's totally understandable. That person might not be for you. Then If they're not in a threesome and you have to have them, well, then you have to respect that this person might not be the right fit for you and you know, move on. Find someone who is into it just as much as you are. It's the same as a lot of other very basic relationship stuff. You got to have enough core value agreement in order for this to have any kind of potential.
Speaker 2:Yeah, and to be clear, both you and I we love our polyamorous brothers and sisters. You guys are awesome. Fully support, we stand, we stand 100%.
Speaker 1:Yeah, I've had several clients get into polyamory or come in already in a polyamorous relationship and go through that. That people in my personal life into polyamory or in various relationship types that are don't fit the mainstream norm. I personally don't give a shit. It comes down to live and let live and respect people's consent and boundaries. I don't see how there would be problem if we all just respect one another.
Speaker 2:Let me give you the opposite version of this question that I think every therapist has heard. Again, I'll speak from the point of view of a prospective client. My partner wants to have a threesome. Should I just do it to shut them up?
Speaker 1:My immediate response is no. If one of you wants to have a threesome and the other one doesn't, again, you got to respect people's boundaries. You need to allow room for people to have informed consent and to talk about this and to communicate and to be heard. Don't engage in things in your relationship that are outside of your boundaries. It creates a lot of uncomfortable emotional responses, a lot of unwanted thoughts. You have the potential to create resentment and that, in a relationship, just causes more problems if they're not resolved.
Speaker 1:If you don't want to have a threesome or don't want to engage in the sexual activity that your partner does, stand firm on your boundary and advocate for yourself. If they continue to push on that, that's something worth exploring. How come they just will not quit on this? What is going on here? Respect that. If that's not for you and it is for them, explore the possibility that maybe we're just not a good match, then I'm on into threesome and you won't stop bringing it up, despite the fact that I've set boundaries. You have to assess and evaluate is this person respecting my boundary? That tells you how safe you are?
Speaker 2:You don't want to find out halfway into a threesome. I don't want to be here anymore.
Speaker 1:Exactly Listen to yourself. If the idea of a threesome is not appealing to you, well then that alone tells you what's going on with you. That's just not a thing for you. If you want to talk about it to see if maybe there's a possibility to be open to it, I don't have a problem with talking about something, but respect your boundary. If, after talking and exploring it, you're still not about it, you're not about it, then that's completely okay. You don't have to be.
Speaker 2:I feel like we should cover our bases and say the opposite is also true. You don't want to find out halfway into this monogamous relationship that you're forcing, that you actually cannot stop being poly and that's just your identity and who you are.
Speaker 1:I love that you bring that up because I've had several clients in the counseling relationship with me struggle with their partner. After sessions I'm starting to notice a repetitive pattern of behavior between them and other people. I will be the one to pop the question have you ever considered polyamory? They'll be like, want to know what that is. I've heard about it. It's just swingers, right? No, it probably looks like that and sometimes it can be that. But polyamory is a bit more in depth than that.
Speaker 1:Poly is usually for individuals who have so much love to give. They have a need to give love and a need to receive love that one person in a monogamous relationship cannot fulfill. For them, polyamory makes sense. You're having this pattern of behavior in which you might be polyamorous. Then they realize they've been married 30 years to one person and that's the reason why for 30 years it's been rough in the very same area. They're not inherently monogamous, they're polyamorous and not living a congruent life. That requires a lot more exploration and processing and potentially conversations with the partner. If they want to bring it up.
Speaker 1:Some of the clients I've had don't. They're like I am poly, but what I have now to me just isn't worth it. It makes. I'd rather continue like this otherwise than give it up and be poly. I respect it If that's truly what you want and need and you are fully aware that that's incongruent to you. But you accept that and that is, for you, your best choice, because that's where you find the most amount of happiness. Well, at least now we're all on the same page, totally fine. Other clients have said I don't see myself or this relationship going well if I don't engage in a polyamorous lifestyle. So yeah, 100%. If you're a polyamorous person trying to live a monogamous lifestyle, your mental health is going to take a beating and eventually something's got to change. Otherwise, it's not going to go well for anyone because your body needs something that's not being fulfilled and it's just going to feel more intense as life goes on.
Speaker 2:So, in the interest of time, I'd like to speed you through some of these questions about marriage.
Speaker 1:Is that?
Speaker 2:okay, rapid fire answers.
Speaker 1:Yeah, go ahead.
Speaker 2:Maybe one, two sentences. Okay, these are again. We'll pretend I'm the prospective client here. I am not attracted to my partner anymore. Is this normal?
Speaker 1:Yes, yeah, there's so much content about this particular topic out there. It is normal attraction. It does come and go. Sometimes, you know, you have these situations which it's there constantly for years, and that's wonderful, that's beautiful. Sometimes it's there and then it just it just one day or over time, it just like fizzles out and it never comes back. And then other times, you know, it's like playing hot and cold. That's all normal and it's totally okay.
Speaker 2:All right. Is there a normal amount of sex that couples should have?
Speaker 1:This term normal. Several of my clients have brought this up to me too. Like what is or is not normal. So if we think of the general public, what a lot of studies have shown is the average person is having sex with their partner, and a monogamous relationship is how most of these studies are based. First off, about two to three times per week. Less so if you have like younger kids or multiple kids. It comes down to like one to two times per week. But what I think is normal is whatever the people in the relationship need and what they all agree to. I've had couples who will say like they have sex, you know, twice a day, seven days a week and less of that. Like they're, you know, feeling like their needs are not being fulfilled and others are happy, like once a month, like that's all they need. It comes down to what do you need and how does that mesh well with your partner and what can you both agree upon of what's healthy to keep the relationship in a happy place?
Speaker 2:Related question how much masturbation is too much?
Speaker 1:For me it's too much when it starts to interrupt your daily functioning, like if you are at work and you can't stop yourself from masturbating. That's not going to go well with your colleagues or your you know your salary and your bills. Also, if you're masturbating to the point where it's like causing physical damage there have been instances in which I've had male clients masturbate to the point where their penis is like bleeding and raw from the friction. I'm like that's not good for you. We need to get you to dial that back quite a bit. So If you're not having daily functioning problems and physically you're not masturbating to the point where it looks like you got into a fight, you're, you're good, it's fine.
Speaker 1:I've had clients tell me they you know Massive rate, like four to six times a day. I ask are you physically okay with that? Is it started to become uncomfortable or any sense of discomfort? And they're like no, like, I'm good. You know it doesn't happen at work, it just happens anytime. You know where it's appropriate. I'm not going somewhere to cause an issue or risk causing an issue. Yeah, you're, you're horny and you're probably just not getting good sex. That's normal. Other times, climbers like I go to work. I just I have to go to the bathroom six times. You know, an eight-hour shift. I'm like, well, that's not gonna fly for your boss and it's interrupting you know, you just being focused at work. So we need to discuss this further.
Speaker 2:Related question on the subject. Should I'm asked right even if I'm married?
Speaker 1:Yeah, that is very normal. So many, so many people will say, like you know you're wasting your libido or it's a form of cheating. Talk to your partner about this if you're comfortable. Right? Some couples will say, like masturbation for them is cheating and that's their boundary. That's totally fine. You know, live and let live. Each person has their own boundary. But masturbation while being married Is not inherent cheating, unless someone in the relationship says that that's their boundary. But masturbating is not. It's just that. It's just you pleasuring yourself and it also gives a sense of variety and we as humans are prone To sexual variety in general. Right, how often do you meet someone who's had one partner their entire life? We're not inherently people who do that, that's just not how we function. So a masturbation is a form of variety to me. You know, I think it better you masturbate than actively cheat. What would you rather your partner catch you doing, right, cheating with another person or masturbating? I think this kind of leads into my next question.
Speaker 2:What if my partner always wants to have sex and I never do? Should I just do it?
Speaker 1:No, I don't agree with that, if it's so quite often in relationships there's like miss, mismatch libidos, and that's not uncommon either. It's very normal for one person to just have a higher sex drive than the other. But if you have the mentality of like I'm just gonna do it just to get them to back off, you're crossing your own boundary and it's just gonna probably at some point cause problems, if it hasn't already. That's something to talk about, right, and there's also a possibility this is where a lot of people get into more open style marriages is because one partner has a higher sex drive that another can't keep up with, and so this is where, like consensual, non monogamy, ethical non monogamy terms come in. But that's a fancy. We have saying, like you have an open relationship.
Speaker 1:Usually, when we see that it's because we're not in a relationship, usually when we see that it's because one person sex drive cannot be Met by just one person, not because they need the variety, but because they just have. You know, they could go Three, four or five times in a day and that's their point of satisfaction, and their partner has, like you know, three times a week in them. What do you do? Right, you start having sex and but you don't want to. I mean, that doesn't feel good. That doesn't feel good, so I would. I would say no. If you're not fully into it, then respect your own boundaries and have a conversation with your partner about how to get each other's needs met.
Speaker 2:Okay, last question about the marriage stuff. Again, I'll be the perspective client. I'm thinking about somebody else when I have sex with my partner. Is this bad?
Speaker 1:It's not bad. People do this all the time. It's normal. Attraction fades in and out. Right libido fades in and out. This is, this is normal.
Speaker 1:If you feel like this is something that's happening constantly, like every time you have sex with your partner, someone else is coming to mind, listen to that. There's probably something going on there. Also, if you're comfortable have a conversation with your partner, what are their boundaries around that? I've had some people tell me you know that to them is a form of cheating. We're just fine, I respect that, and others are like no, go for it.
Speaker 1:You know, it's not like you're actually cheating on me, you're just thinking about that person every once in a while. And then some will say, like, sure, you can think about that person, but only once a week. Anything more than that and that's past my boundary and this is why it's so important to communicate all of these Delicate and uncomfortable topics is to find people's boundaries. So you, the fact that you do this, you, the listener, that is not bad, it is normal. Lots of people do it. Listen to their frequency and, if you're comfortable, talk about it with your partner. See where you feel about if this was to happen to you as well.
Speaker 2:Right, I know, and I I feel like we can go into depth on this. I am mindful of time, though. Do you want to go into depth, or should or should we power through I?
Speaker 1:Think power through. It is a super fun topic, but I also know we have like a lot of cool shit coming up as well.
Speaker 2:Okay, so I I want to quickly talk about finding a sex therapist. Is there a governing body for sex therapy? For example, for doctors, they have to be board certified. Is there a board certified for sex therapists?
Speaker 1:So there are certifications the most popular one because there's several, but the most popular one is the American Association of Sex Education counselors and therapists. Now, when people bring this up to me, the first thing I tell them if you're looking at a mental professional, the most important governing body is the state government, because, as a licensed professional, I am registered and licensed with my state and for me that's the state of Colorado. So if anything happens, I do anything I shouldn't do, or if someone has a problem or someone needs to know something about me, or it has an issue of any kind or a question, colorado state is the one who governs me, regardless of my specialties, because the your local government, your state government, supersedes any of the boards out there, because it's Governments, actual government. Now, there's plenty of boards. Right, I'm part of the National Board of Certified Counselors. Right, if I get in trouble with them, they might kick me out of their organization, but I'm still allowed to practice like a therapy through my state.
Speaker 1:So that's why I tell people the state is the most important governing body. Everything else is secondary, it's like a supplement. You can, you know, look into the, the American Association of Sex Education, and see what they're about find a therapist there. If you have an issue with a therapist you had, you can go to them, but effectively your state government is where you want to go if there's any kind of concern or questions or problems or anything like that, because that is the most important governing body, because that is the person who holds my license, not any of these board certified organizations.
Speaker 2:Should I care about this? What pretend I'm a client? Should I care about this when I'm looking for a sex therapist? If a sex therapist is a sex train, does that mean they're better?
Speaker 1:I love this question. So people in the area of sex therapy is therapists. It is back and forth. So this is my personal opinion, which does differ from other sex therapists, and I'm going to go ahead and say no, it does not need to be board certified. They do not need a certification and the term sex therapist is not a government protected term. For example, I've called myself a psychotherapist. That's not a exactly protected term. But when a therapist says they are a licensed professional counselor or they are a licensed addictions counselor, that is a government protected term. You can't say that without having the backing and the credentials. So I'm allowed to call myself a sex therapist and not be certified. I don't need the certification to say it. What the certification does? Honestly, for those of you who are really confused about licensing and certifications, the certification just proves that they did extra work. That that's it. It's just they spent money on extra work and extra trainings to get extra supervision and get certified.
Speaker 2:You don't need that in order to be good at this.
Speaker 1:That's the big caveat.
Speaker 2:Sorry, I was going to ask. There is a division of the APA for psychologists that does sex therapy, though, right?
Speaker 1:I believe. So I haven't looked at too much into like fully understanding it because I don't have a degree, like I don't have a PhD in psychology. I think they have their own classification. Most people from a client perspective end up looking for a sex therapist, who tend to be master's level clinicians like ourselves.
Speaker 2:So I did clarify. I can't believe I knew this. So I can't say I know nothing about sex therapy anymore. So there is a division. So for people who don't know, psychologists or doctorate level degree and APA, american psychologists are in different divisions and you can specialize and one of them is the division of sexual orientation and gender diversity. However, for master's level clinicians you don't have that same specialization. So most of these certifications, like James is saying, are mostly not regulated by any state governing body. They're kind of made up.
Speaker 2:I'm doing a related deep dive on this right now, so that's why I'm passionate about it. I think the idea of certifications the spiciest opinion I have. They should be outlawed because I think it's confusing for clients to say you're certified by ASEC. Does that mean, like you said, you have a license from the state and that a therapist who doesn't have that does not have a license from the state? Just in case any of our listeners are wondering how Angela feels about this, I looked into the clinical literature on ASEC and I think I found like five or six articles. There is no evidence based suggesting ASEC training improves therapy outcomes. Anyway, go ahead, james.
Speaker 1:Correct. Yeah, so I've done my own certifications in like anxiety and depression I think, a couple of other things and what I noticed from my own personal experience. The certifications didn't do me any good and I did look at getting a certification for sex therapy and I did about 40 hours of sex therapy training and it was 40 hours of how to be accepting. It was just for me pointless. It was a lot of money Like those 40 hours. I think it was like around $1,500, $2,000 of videos and all I got from it was be an accepting sex therapist.
Speaker 1:There's no clinical techniques, there's no differences in how I treat people. So to me I'm not actively pursuing a sex therapy certification because I don't need it. It's not teaching me anything new. There's no requirement for me to engage in sex therapy or sexual counseling and, as Angela had mentioned, it's not regulated by anything that's relevant to me. The state regulates what I do. What I do it all goes through the state of Colorado because that's where I hold my credentials. So if the state of Colorado changes policies around therapy, I have to abide if I want to keep my career going. But if a governing board like the American Association of Sex Education Counselors and Therapists, asac changed their policies. I don't have to listen to that because they don't hold my license. They hold my certification and that certification comes at a heavy cost that doesn't add anything.
Speaker 1:As Angela mentioned, finding a certified therapist in anything in particular does not improve quality of care for the client. That's all that it does. So my opinion on certification for sex therapy no, it is not important, because and Angela and I have talked about this in the previous podcast episode together if you get someone who's clinically amazing with their technique but you cannot relate to them and feel safe to open up, who gives a shit, it's really irrelevant then. So the most important thing I tell clients when they're looking for a potential sex therapist is find someone who you feel safe to talk to, that is licensed, that does have training, that does have credentials, to make sure that it's legitimate therapist, and see if you feel safe to talk to that person about what's going on with you. And let the certifications be damned. They don't add that much in my opinion.
Speaker 2:Okay, James, I think that's it. That's all my questions about sex therapy.
Speaker 1:Awesome. Well, this was a first for me to be interviewed by another therapist on my podcast. I definitely like it. This might be a format I'll reengage in in the future to have people ask me questions in the interview style, because it's a lot came up. There's even some stuff we couldn't get into, unfortunately, but you know, that is how things are. When you have a roughly hour long recording For all of you listening, we're running to the end, angela, before we sign off. Thank you so much. This was absolutely amazing. You had such a brilliant idea. I think you are an absolutely amazing co-host for this episode and I look forward to doing more things like this with you in the future and all of your insight and you're just your wonderful personality. Thank you for coming in here and interviewing me.
Speaker 2:Of course, james an interested listeners can come find me at my website, gnostherapycom, or on Twitter as contest to sacks James.
Speaker 1:I will go ahead, listeners, and put her info into the description of this podcast. So, if you like her style, you think she's a good fit for you, or if you just ask some questions for Angela that you believe she could help you out with, read the description, find her info, reach out and that's it. Everyone, wonderful episode. Thank you, angela and to the listeners. I'll catch you again next time.