Sex, intimacy, and desire discrepancy may be the most common concerns couples bring to me, and they’re also some of the hardest to talk about. By the time a couple reaches me, they’ve often spent years quietly misreading each other’s behavior and feelings. One partner might think, “They must not find me attractive anymore.” The…
Treatment Approaches
Quiet Knowing: Finding Your Wise Mind
Have you ever known what you needed to do before you could fully explain why? Some people call this a “gut instinct,” others intuition, an inner voice, or simply a sense of knowing. There have been plenty of times when listening to my gut has served me well, and other times when my gut has…
5 Acceptance and Commitment Therapy (ACT) Metaphors We Love
If you spend any time with a therapist who is trained in Acceptance and Commitment Therapy (ACT), you will notice something striking: they like to speak in metaphors. You might hear about switch that can be flipped on or off, or an experience of getting caught in quicksand, or someone standing in a hole with…
The Freedom of Radical Acceptance
Most of us spend an incredible amount of energy fighting reality. We argue with traffic. We replay conversations that already happened. We wish our partner communicated differently. We think our children should appreciate us more. We tell ourselves we shouldn’t feel anxious, sad, overwhelmed, or lonely. We wish our body looked different. We wonder why…
The Only Way Out of Anxiety Is Through It: Exposure and Response Prevention
There’s a particular kind of exhaustion that comes from managing anxiety instead of living your life. Rehearsing the conversation you’re avoiding. Circling back to check the stove, the lock, the windows. Ruminating on a thought you can’t shake. Avoiding situations that make you uncomfortable. Googling symptoms. Struggling with anxiety can feel like a full-time job.…
Attachment and Modern Dating
Understanding Attachment and Modern Dating In the modern world, we’ve seemingly hacked the dating system. We have dating apps, instant communication, and constant access to potential partners, yet dating still feels complicated, confusing, and emotionally exhausting. Many people are still left wondering, why does it feel so hard to date? Cultural shifts may offer part…
10 Things Your Therapist Wants You to Know About STIs
Sexuality transmitted infections (STIs) can bring up a lot – fear, shame, confusion, overwhelm – not to mention a ton of unanswered questions or worries. As sex therapists, we often see how these feelings of overwhelm and worries of stigma can make an already stressful situation even heavier. Here are ten things I wish everyone…
Harm Reduction in Psychotherapy: A Therapist’s Guide
When psychotherapists think of harm reduction, many immediately picture syringe exchange sites, overdose prevention kits, or community-level substance use interventions. Although these interventions are critical for keeping those who use substances safe, harm reduction is far broader than just these interventions. A harm reduction lens is profoundly relevant to everyday psychotherapy, and can complement so…
When the Body Speaks: Erectile Dysfunction and Mental Health
A Silent Reality for Millions For millions of men, Erectile Dysfunction (ED) isn’t just physical; it’s personal, emotional, and often carried in silence. In the U.S. alone, an estimated 30–50 million men experience erectile dysfunction. Despite how common it is, ED remains one of the most misunderstood and least openly discussed health challenges. Yet science…
Why You Can’t Relax: Self-Criticism, Overcontrol, and What to Do About It
In a society that highly values productivity, perfectionism, and doing things right, it is easy to believe that we would not be as successful, functional, or achieving if we were not hard on ourselves. Common Self-Critical Thoughts Have you ever had thoughts that sound something like this? This type of thinking can give us the…
