Sexual Addiction and Sexual Issues

Sexuality is a very important part of life and working on it to clear up problems will provide many benefits. People I work with are usually able to stop their problematic sexual behavior and experience more intimacy and sexual satisfaction with their partner - or move towards finding a healthy partner. My specialty is doing psychotherapy with people with sexual addictions / compulsions and all kinds of sexual problems including intimacy and relationship issues (21 years in the Bay Area). I have offices in San Francisco and Marin county.

My therapy approach is designed to do the two most important things to help people:

1. Stop the damaging sexually addictive behavior.
I work with you to design a treatment program tailored to your needs so that you can effectively stop the behavior as soon as possible that is damaging your life.

2. Resolve the root cause of the addiction so it doesn't re-surface later.
I use a 2-step process for deeper work. I work to help you understand first how and why the addiction developed. This work is to essentially find the root of the problem.  The work on this first step is to make sure that what we find really fits – it has to ring true for you.  The focus in the second step is to work at this root cause - to heal and resolve it.  This second phase of the work is the nitty-gritty work of therapy where old wounds and trauma are worked on for healing and old patterns are worked on to be resolved and mastered. 
For this deeper work I use a type of therapy called Coherence Therapy. Please scroll to the bottom of this page to read more about this kind of work. It is a whole new paradigm in psychotherapy - it goes deeper and resolves the problematic behavior much faster than most other forms of therapy.

Call 415-221-3182 or click here to contact me about psychotherapy or to ask any questions you have.
All calls and emails are completely confidential.

Take the test - if you answer YES to 3 or more of the following you may have a sexual addiction:
Do You...

• Put yourself & others at great risk by engaging in unsafe sex?
• Become irritable if sex is not available?
• Believe that sex is your most important need?
• Buy porn or regularly visit "adult" websites?
• Have others tell you - "all you think about is sex"?
• Feel ashamed of your sexual impulses?
• Repeatedly pressure your spouse for sex?
• Lie to get sex?
• Have sexual contact with strangers, multiple partners?
• Use sex to relieve tension?
• Lie to cover up sexual acts?
• Feel at times that your sexuality is out of control?
• Sometimes swear you will never express your sexuality in a particular way again, but repeat the behavior anyway?
• Worry that your secret life might be revealed?
  

Signs of Sexual Addiction:

• Loss of control of sexual impulses.
• Negative consequences from sexual behavior.
• Loss of discrimination toward sexual objects or partners.
• Preoccupation with the search for sexual outlets.
• Increased but not emotionally satisfying or pleasurable increase in sexual drive.
• Ritualizatin resulting in a trance-like state with a blocking of reality & real world consequences.
• Living a secret sexual life filled with shame and lies.
• Violating your own ethical, moral and professional values.
• Persuing sexual interests obsessively despite personal and financial risks.
• Using sex to relieve or escape anxiety.
• Difficulty in connecting feelings of intimacy and love with sexual behaviors.

The basic way to determine if you have a problem is if your sexual behavior is causing damage in certain areas of your life, including your relationships, your career, or your emotional, physical and spiritual well-being. The 2 main signs of an addiction are loss of control and negative consequences due to the behavior. In other words, if you are unable to control your sexual behavior and you're having negative consequences because of the behavior it is accurate to say you have a problem and should seek help.

Additional Notes about the way I work:

Many people with a sexual addiction have an intimacy issue and for this issue I work to help improve intimacy levels in relationships.  In other words, people with this issue need to learn how to develop real intimacy with another person. The sexual addiction is the symptom showing there's a problem in this area.  Many people with an intimacy issue still need to work on the sexual addiction, but as the work proceeds and the sexual addiction issues get resolved, I focus more on the intimacy issue and how to develop it with a partner.  If the person does not have a partner, I work to help people learn how to choose a healthy partner with the goal of healthy intimacy.
 
My style of working is basically client-centered which means that in any particular session, I work with whatever is most important to talk about and go from there. I am very supportive and positive, and I work to empower clients to achieve life goals. I use empathic listening, reflection and explaining to assist people in going deeper and clearing out whatever is in the way of achieving goals, resolving problems, and feeling better.  I use several tools for working with trauma: EMDR, Traumatic Incident Reduction (TIR), and Somatic Experiencing work. Please see the article at the bottom of this page to learn more about Coherence Therapy which offers a whole new paradigm in psychotherapy - one that makes the healing process go much faster, more effective and longer lasting than traditional psychotherapy.

I also work with couples. I like to see an individual with a sexual addiction for several months or more before I see both partners.  The initial work is to help the partner without the addiction heal from the betrayal and break of trust.  As this healing progresses, more focus is put on improving the relationship.  I work to assist partners in clearing up communication difficulties, dysfunctional relationship patterns, and uncovering the vulnerable feelings that are often hidden in power struggles and trust issues. I ultimately work towards the goal of more connection and intimacy, while working with whatever material comes up and gets in the way of intimacy, or is triggered by intimacy.

I have an MA in counseling psychology from the California Institute of Integral Studies (1989). I've been in private practice since 1988. In addition to my work with sexual addiction, I also work with relationship issues, depression and anxiety, childhood abuse and neglect, career problems, self-empowerment issues and spiritual issues.

Please feel free to call or email me for an appointment, for more information or for any questions. I have offices in San Francisco and in Marin county.

Call 415-221-3182 or click here. All calls and emails are completely confidential.

My fee is $125 for a 50-minute session. I sometimes have slots open for clients who need a lower fee.  

Mark Robinett, MFT     e-mail mrobi@sonic.net        Office Phone (415) 221-3182      Fax (415) 459-0362

Office Locations       San Francisco	Marin county
5028 Geary Boulevard San Francisco, CA 94118	610 D Street, Suite A San Rafael, CA 94901
CA License #MFC29231

Coherence Therapy* for Sexual Addiction & Problematic Sexual Behaviors
by Mark Robinett

I use a type of psychotherapy called Coherence Therapy to resolve and dissolve the roots of problematic sexual behavior.  Coherence therapy is a new paradigm in psychotherapy – a much faster and more effective method than traditional therapy.  It is the quickest and most efficient way to go into the depth of a problem and resolve it at its root.  Coherence therapy works by first using a technique called radical inquiry to find out where inside of a person the problem or symptom is coherent.  In other words, there is usually a part of a person that uses the symptom for a very important reason, however this reason has been up to now unconscious.  In the discovery process of radical inquiry, the reason for the symptom is discovered and made conscious.  When a client presents a problem of sexual addiction or some kind of problematic sexual behavior, the first step with this method of therapy is to do radical inquiry to find out where in the person the sexual addiction behavior is necessary.   Once this is discovered – and while it rarely makes much sense to the person consciously – to the part of the person that is invested in the behavior, it not only makes sense, but is believed to be absolutely necessary.  In this style of work what matters most in triggering lasting change is for the client to find and experience the already-existing but hidden emotional meaning that the problem has for him.  This is always the most strongly meaningful view of the problem and it always opens up avenues to rapid change.  And the reason rapid change can happen here is because in the hidden emotional meaning of the problem is where the emotional origin is and once it is opened up it is very fluid and available for change - usually then with some kind of specific experiential work.

The theory behind Coherence therapy is called constructivism.  Basically this theory says that we construct pretty much everything that is inside of us as basic beliefs or schemas of meaning.  In other words, we construct beliefs consciously and unconsciously that we use to understand our world and to give our world meaning.  However, nearly all of this constructing and assembling of reality is done unconsciously, both at the neurobiological level and at the social-psychological level of assigning meanings to perceptions.  We basically get lost in our own construction of reality because we are unaware of our role as its construer-author.  Looking at an individual in this way means that whatever a client defines as the problem – be it a sexual problem, depression, or anxiety – is seen not as a sign of pathology but is seen in terms of a problem that is constructed coherently by the person’s currently operating constructions of meaning (belief systems).  Another way to put this is that whatever problem a person is struggling with has been generated entirely by the individual’s cognitions and emotions comprising his or her present construction of reality.  The therapeutic task then is in assisting the client to further evolve his construction of reality in such a way that the presenting problem is alleviated.  This is approached as an intrinsically progressive and creative process rather than a corrective or curative one.  So the work is not to focus on the symptoms to diminish them and produce more agreeable, less symptomatic conditions within the same view of reality.  Rather, the approach is to usher the client into an alternate view of reality that does not include producing the symptom and this is a much deeper and more permanent change. 

In constructivist theory then a client’s presenting symptoms are the unacceptable costs or consequences of the client’s current way of construing reality – in other words for a person who has problematic sexual behavior – this itself is the unacceptable cost and almost always why the person comes to therapy, but what the client does not yet know is that these costs (of the behavior) are due to a way he or she has a certain constructed unconscious reality.  And because it is the client who set up this construction of reality in the first place, it is the client who can change it, if skillfully guided to do so, in order to eliminate those unwanted consequences.  Competently executed, this approach tends to result in particularly durable therapeutic change and can occur rapidly.  

For example, a man started therapy with an addiction to online porn.  His live-in girlfriend had found out about it and was furious and felt like it was cheating on her.  Using Coherence therapy we quickly discovered that the use of porn was mostly in response to work stress.  And as we went deeper into it, the work stress was because he took on too much responsibility at work and never talked with anyone about the burdens on him because he believed that (we discovered three unconscious beliefs - all connected); (1) no one wanted to hear his feelings or complaints, (2) it would not do any good at all to voice them, and (3) using porn was the best way to deal with the stress and it worked – at least in the moment.  Most psychotherapy at this point would then focus on trying to “talk” him into changing these beliefs or in trying to “talk” him out of these beliefs – and this could be a long and arduous process, and not necessarily successful or long lasting.  Using coherence therapy methodology I focused on the beliefs we’d discovered  and worked to really capture the emotional truth of each of them.  For example – the first belief – that no one wanted to hear his feelings or complaints we worked on by having him voice this belief to his co-workers, particularly his superiors in a visually imagined scene, using the statement; “I know you don’t want to hear how I feel about taking on so much work – so I won’t express my feelings to you – I’ll keep them to myself and find another way to deal with it”.   When he did this he said it felt very true – this is how he really felt.  In this method of work, I didn’t try to talk him out of it or try to get him to change this.  What I did was encourage him to really feel the truth of this and voice it.  In this kind of work, we stay right here until it does change.  As he did this, within about 10 minutes he began to say that maybe he could speak up more; maybe he could give it a try to express his feelings to his bosses.  This new development started happening because once his emotional truth was expressed and felt consciously it was then opened up to change by being exposed to another reality – the reality he now was considering of expressing his feelings openly.  If a person tries to change a belief like this by staying in his head about it – by intellectually talking about it and thinking that he should change it and even deciding to change it, it usually won’t change because the emotional construction hasn’t opened up and that is where the deep construction of the belief is held (in the limbic system of the brain).  This is why it’s so hard to change most problems.  At the end of this session I gave him a note card that had a similar statement on it – If I express my feelings to you about having too much work you won’t want to hear it – so I won’t do it  – I’ll keep them to myself even though it puts me at risk to looking at porn again.  This statement was crafted to put the emotional truth and unconscious belief in contact with the conscious consequence of the behavior and then see what this client would do with it.  In the next couple of sessions we did similar work with the next belief that was most likely part of the same unconscious construct.  Within two more sessions he said that pretty much all the work stress was gone, he was talking to co-workers and bosses about his frustrations and difficulties and was feeling a huge relief in this – like he was free and the same as everyone else at work – no longer feeling alone in his misery there.  He still felt stressed at times but it was OK because he was talking about it now and didn’t feel alone in it.  He still had a little trouble with the urge to look at porn come up from time to time, but it was about 5% of what it had been.  As we worked on this final issue, these last remaining urges, it became clear to him that his girlfriend would be the much better replacement when the desire for porn came up – and he did this without me suggesting it – a good example of an unconscious construct of the desire for porn being explored and getting put right next to another possible reality – that of being sexual and or affectionate with his partner making the original construct dissolve.  This last change happened very quickly in one session and it was interesting to watch the change in him as he told me it just didn’t make any sense anymore to look at porn when he had his girlfriend so available.  All of this client’s change and resolution of the sex addiction to porn occurred in 9 sessions over the course of about 4 - 5 months. 

My experience using Coherence therapy for sexual addiction is that the time of resolution of the problematic behavior varies from client to client – not everyone’s behavior changes as quickly as this client’s did.  However, this kind of work is probably about 2 - 3 times faster than traditional therapy, and the change seems much more permanent.  One additional note is that if a person also has trauma or PTSD symptoms that are causing the problematic behavior, trauma resolution techniques must be used in addition to Coherence therapy methods.  I use techniques such as EMDR (Eye Movement Desensitization and Reprocessing) or TIR (Traumatic Incident Reprocessing) and they are very effective for this. 

*Developed by Bruce Ecker, M.A., MFT and Laura Hulley, M.A., MFT 
For more info on Coherence therapy visit www.coherencetherapy.org
and case examples at http://www.coherencetherapy.org/discover/examples.htm