Setting Boundaries: How to Stop Being Enmeshed With Your Family

I began a discussion about enmeshment in an earlier article, Overcoming Shame in an Enmeshed Family.

Overcoming Enmeshment in Your Family

Topics in the Current Article

In the current article, I'm covering:

• What is Enmeshment?
• What Causes Enmeshment in Families?
• How to Overcome Enmeshment
• Getting Help in Therapy to Overcome Enmeshment

What is Enmeshment?

If you grew up in an enmeshed family you probably had at least some of the following issues:

• There was a lack of physical and emotional boundaries.

• There was a tendency to focus on what's best for other family members and not what's best for you.

• You put other family members' happiness above your own.

Overcoming Enmeshment in Your Family

• You feel guilt and shame, as an adult, if you put your needs above other family members. For instance,  you might not want to call your mother every week, but you feel guilty and ashamed if you don't because you know she wants you to call weekly.

• Your family's self worth is dependent upon your success.

• Your family expects you to share everything about your life--even things you might want to keep private. They get offended if you say something in your life is private.

• Your family might have imposed their ideas on you when you were a young adult instead of encouraging you to follow your own hopes and dreams. If you wanted to follow your own aspirations, they felt offended and you felt guilty and ashamed.

• Parents in enmeshed families tend to treat their children like friends instead of children because there is a lack of boundaries.

• You tend to avoid conflicts, even now as an adult, because you have difficulty setting limits.

• You lack a strong sense of who you are.

• You absorb other people's emotions around you because you lack appropriate boundaries (this is different from being an empath).

What Causes Enmeshment in Families?

Enmeshment usually develops in dysfunctional families and repeats the pattern from one generation to the next (see my article: 

Overcoming Enmeshment in Your Family

It can be difficult to pinpoint when an enmeshed family dynamic started since it might go back generations and family members often have little to no awareness about the enmeshment.

Enmeshment often develops due to unresolved trauma, mental health problems, substance abuse, compulsive gambling or other related issues.

What is the Impact of Enmeshment in Adult Relationships?

The following characteristics are common for adults who grew up in enmeshed families?

• Low self esteem
  

• Anxiety
  

• Fear of abandonment
  

• Being out of touch with your feelings

• Feeling burdened by guilt and shame

Overcoming Enmeshment in Your Family

• An overdeveloped sense of responsibility

• Poor personal boundaries

• Difficulty setting boundaries with others

• Codependency
  

• Difficulty with assertiveness

• Difficulty with emotional regulation 

• Difficulty calming or soothing yourself emotionally

Clinical Vignette

The following clinical vignette, which is a composite of many cases, illustrates the negative impact of enmeshed family dynamics and how psychotherapy can help:

Maria

Maria grew up in crowded family home where she shared a bed with her two older sisters. She had no privacy. 

When Maria was 15 years old, her oldest sister found Maria's diary, she read it to their parents, grandparents and siblings and they laughed at what Maria wrote about feeling sad.

Her parents and grandparents invalidated her feelings and told her she had nothing to feel sad about since she had a roof over her head, food and clothing.  They told her that only someone who had something terrible to hide from the family would even want to write in a diary.  Then, her father tore up her diary and threw it in the garbage. He told her she should be ashamed of herself for what she wrote.

When she turned 16 years old, Maria's maternal uncle, who came to live with her family, began touching her inappropriately when no one was around. He told her that he would hurt her sisters if she told anyone about the sexual abuse (see my article: Overcoming the Trauma of Sexual Abuse).

One day her mother happened to come home early and she found her brother touching Maria's breasts. She threw her brother out of the house and she also blamed Maria for the sexual abuse.  

She told Maria it was her fault that the uncle touched her inappropriately. Then, she made Maria promise not to tell Maria's father because she feared what he might do to the uncle if he found out.

When it was time for Maria to choose a major in college, her parents insisted that she become a teacher--even though Maria wanted to become a medical doctor. Her parents told her that women shouldn't become doctors because they would have to see men's naked bodies and this was shameful for a woman.

Maria was upset that her parents were trying to force her to choose a career she didn't want so she sought help from a professor who referred her to the college counseling center.  

In counseling, Maria learned to set boundaries with her family--even though they didn't like it and they threatened to stop paying her tuition.

Overcoming Enmeshment in Your Family

Her counselor helped Maria to get a scholarship and a room in a dorm so she could live independently from her family.  She took pre-med courses and, eventually, she went to medical school.

While she was in medical school, she sought help from a trauma therapist so she could deal with the impact of her enmeshed family, including the sexual abuse.

Even though her family didn't like that Maria was making her own decisions and setting boundaries with them, they accepted it reluctantly.  

While she was in medical school, Maria met her husband-to-be and she learned to have a healthy relationship with him with the tools she learned in therapy.

How to Overcome Enmeshment

To become a mature adult, children need to learn to become their own person at stages that are appropriate for their development at the time.  This is part of the individuation process.

Individuation means being your own person and not just an extension of your parents and other family members.

When you are appropriately individuated from your family, you can maintain your relationships with them with appropriate boundaries. You also learn how to be your own person physically, emotionally and psychologically.

To overcome enmeshment, you need to learn to:

• Set appropriate boundaries with family members (see my article: How to Set Boundaries Without Guilt).

• Discover who you are as an individual apart from your family.

• Learn to stop feeling ashamed and guilty if what's right for you might make your family unhappy.

• Get help in therapy when trying to overcome enmeshment becomes too challenging.

Getting Help in Therapy

Overcoming enmeshment can be challenging.

Getting Help in Therapy

A licensed mental health professional with the right expertise can help you to develop the skills you need to overcome enmeshment and develop healthier relationships.

Rather than struggling on your own, seek help from a skilled psychotherapist so you can lead a more meaningful life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapy.

As a trauma therapist, I have helped many individual adults and couples to overcome trauma, including enmeshed relationships.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Arousal Non-Concordance and a History of Sexual Abuse

In an earlier article, I wrote about arousal non-concordance to explain what it is and to normalize it as a common experience for many people (see my article: What is Arousal Non-Concordance?).

Arousal Non-Concordance and a History of Sexual Abuse

What is Arousal Non-Concordance?

Arousal non-concordance occurs when there is a disconnect between how someone feels physically and how they feel emotionally and psychologically.

Arousal non-concordance can occur when someone feels physically aroused, but they don't want to have sex. 

It can also occur when someone wants to have sex, but they don't feel physically aroused.

What is the Difference Between Sexual Desire and Sexual Arousal?

Arousal non-concordance highlights the difference between feeling sexual desire and sexual arousal.  

Sexual desire is a psychological state. It's a state of mind which is often described as being "in the mood" to have sex.  Desire is often influenced by thoughts, emotions and the particular context a person is in.

Sexual arousal is a physical response which can include changes in erection and lubrication. 

Sexual arousal is often triggered by visual or physical cues or memories.

Sexual desire and sexual arousal often go together--but not always. This is evident with arousal non-concordance.

Examples of Arousal Non-Concordance

The following short vignettes are just a few examples of arousal non-concordance:

• Liz and Jane: Liz feels sexually turned on when Jane kisses her. But when Jane touches Liz's genitals, she discovers Liz feels dry. As a result, Jane assumes Liz doesn't want to have sex so she stops kissing her. She assumes that if Liz was turned on, she would be lubricated. So, Liz tells Jane that, even though she's not wet, she really wants Jane, so they continue to kiss and make love.

• Mary and Bill: Bill touched Mary's genitals and she knew this meant he wanted to have sex. But she had a headache and she wasn't in the mood. She told Bill that she loves him, but she would rather wait until the morning to have sex after her headache goes away. Bill was confused and said to Mary, "You're so wet. I don't understand how you're not in the mood." Mary explained to him that her body was sexually aroused, but she wasn't  desiring sex at that moment. By the morning, Mary's headache was gone away and she and Bill enjoyed sex.

• John and Ed: John and Ed were in bed when John told Ed that he wanted to have sex. But during foreplay Ed noticed that John wasn't getting an erection so he stopped kissing and touching him because he assumed that John didn't desire him. At that point, John explained that, even though he really desired Ed a lot, he sometimes had problems having an erection when he was anxious. He said he just needed to relax. So after they cuddled for a while, John felt calmer and he was able to have an erection.

Arousal Non-Concordance and Memories of Sexual Abuse

Arousal non-concordance can occur under many circumstances, including while having memories of sexual abuse (see my article: Overcoming the Trauma of Sexual Abuse).

Arousal Non-Concordance and Memories of Sexual Abuse

The concept of arousal non-concordance is important to understand when there is a history of sexual abuse.

Many children and adults, who were sexually abused, might have felt physically aroused when they were being abused--even though they had no desire to be sexual with their abuser. 

This happens because the body can become sexually aroused even though the person has no desire to have sex (see my article: Coping With Trauma: Managing Sexual Abuse Triggers).

It's common for people who were sexually abused to get confused about why they get physically aroused with these memories because they don't know about arousal non-concordance. They feel like there's something wrong with them or they were to blame for the sexual abuse. But, in fact, there's nothing wrong with them at all and they're not to blame.

Everyone is different. Some people who were abused feel ashamed and guilty about getting aroused by the memories.

Other people accept their arousal as a common experience and they're not bothered by it.  

Other people incorporate their earlier experience in a roleplay with a partner to feel empowered. In other words, when the original experience occurred, they had no control over what was happening to them. But in a roleplay with a partner they use their imagination to feel in control and they experience a different outcome. 

In that sense, the roleplay becomes healing for them.

Getting Help in Therapy

Most licensed mental health professionals have no sex therapy training and don't understand arousal non-concordance.

Getting Help in Therapy

If you want to work through issues around arousal non-concordance, including a history of trauma, you need to work with a psychotherapist who has training in both sex therapy and trauma therapy.

Rather than struggling on your own, seek help from a psychotherapist who has the expertise you need so you can live a more fulfilling life.

About Me

I am a licensed New York psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

With over 20 years of experience, I have helped individual adults and couples to resolve sexual and/or trauma-related issues (see my article: What Are Common Issues Discussed in Sex Therapy?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Coping With Trauma: Managing Sexual Abuse Triggers

I've written about trauma related to sexual abuse in a prior article (see my article: Overcoming the Trauma of Childhood Sexual Abuse).

In the current article, I'm focusing on sexual abuse triggers, which are common experiences for many adults who experienced childhood sexual abuse (see my article: Coping With Trauma: Becoming Aware of Triggers).

Managing Sexual Abuse Triggers

Sexual abuse occurs regardless of age, gender, sexual orientation, race, ethnicity or other identifying factors.

Childhood sexual abuse can be especially confusing because children are emotionally and physically vulnerable. 

Sexual abuse often occurs when children are told they can trust certain adults, including a parent, sibling, other family members, family friends, babysitters, teachers, pastors/religious leaders and others who turn out to be sexually abusive.

Managing Sexual Abuse Triggers

When children are sexually abused by people they're told they can trust, they often don't know how to react to the abuse or what they should do.  

Worse still, people who sexually abuse children often threaten children if the children reveal the abuse. They might tell them that the child will get in trouble or that they could be taken away from their parents. This often forces children into silence.

Even when children reveal their sexual abuse to adults, adults might not believe them--either because the adults are in denial about the situation or they might have their own blind spots about sexual abuse because of their own unresolved experiences.

What is a Trigger?

Generally speaking, a trigger is an experience that brings back a previous traumatic experience.

The trigger can result from something you see, hear, smell, taste or feel (tactile). 

    Examples of Sensory Triggers

Here are some examples of sensory triggers:

• Visual Triggers: 
• You see someone who looks like the person who sexually abused you.

• You see a location that looks similar to where you were abused.

• You see a TV program, movie or a broadcast news story that reminds you of your experience.

• Sound Triggers:
• You hear a sound that is similar to what you experienced as part of your trauma (e.g., the sound of someone coming up the stairs might remind you of what you heard just before the person who abused you entered your bedroom).

• You hear a song you heard when you were being abused.

• You hear a voice that is similar to the voice of the person who abused you.

• Scent Triggers:
• You smell alcohol which is similar to the smell of the person who abused you.

• You smell cologne, which is similar to the scent of the person who abused you.

• You smell the type of food that was being cooked downstairs while you were being abused in your bedroom.

• Taste Triggers:
• You taste a particular food that is associated with your experience of sexual abuse.

• You taste a particular alcoholic drink that was given to you by the person who abused you.

• You taste a particular candy that your abuser gave you.

• Touch Triggers
• You experience a sense of touch by someone in your current life (e.g., a hug from a friend or a touch on the shoulder) that reminds you of how you were touched by the person who abused you.

• You experience a sexual touch by your partner as being similar to what you experienced with the person who abused you.

• You experience the sensation of a particular fabric that you associate with your history of abuse.

    Examples of Other Types of Triggers: A trigger can be anything. Here are just a few examples of other types of triggers:

• You feel triggered by your partner's compliments because the person who abused you would compliment you.

• You feel triggered by a stranger's gaze because the person who used to abuse you also gazed at you in the same way.

• You feel triggered when your friend gets angry with you because the person who abused you got angry with you whenever you tried to set boundaries with them.

How You Experience Triggers

Some triggers can transport you back to the original trauma in terms of bringing you back directly to that experience in the form of a flashback.

Managing Sexual Abuse Triggers

Depending upon your particular experience, you might feel like you're actually back in that memory and lose awareness of your current surroundings. Or, you might remain aware of your current surroundings, but the experience brings a strong reminder of the traumatic memories.

Other triggers might not completely bring you back to the original trauma, but you might experience the emotions related to the abuse (see my article: What Are Emotional Flashbacks?).

Coping With Guilt and Shame

Many people who were sexually abused as children are aware on an intellectual level that they were not to blame for being abused.

But, on an emotional level, they might experience guilt and shame and blame themselves for the abuse (see my articles: Overcoming Shame and Overcoming Guilt).

Coping with Shame Related to Childhood Sexual Abuse

In retrospect, you might be experiencing guilt and shame for not being able to stop the abuse (What is the Difference Between Guilt and Shame?).

You might also feel guilt and shame for experiencing physical pleasure, which is a normal bodily response--even though you didn't want the abuse to occur.

No matter what your experience of guilt and shame, you were not to blame for what happened to you.

Coping With Guilt Related to Childhood Sexual Abuse

Managing Sexual Abuse Triggers

• Getting Emotional Support From Trusted Loved Ones: If you have trusted people in your life who know and love you, you can seek emotional support from them. Just being able to talk about what happened to you, instead of keeping to yourself, can be helpful--but only if you're sure this person will be supportive.

• Practicing Grounding Techniques: Grounding techniques help you to calm yourself when you're being triggered (see my article: Grounding Techniques).

• Accessing a Supportive Part of Yourself: The sexual abuse trauma can be located within a traumatized part of yourself, but you also probably have other positive parts that can help with positive self talk to help you when you're feeling triggered.

• Seeking Help in Trauma Therapy: Supportive loved ones can be helpful, but they can't help you work through the unresolved trauma. A skilled mental health professional who is trained as a trauma therapist can help you to overcome triggers, develop a more resilient self and help you to free yourself from your traumatic history (see my article: Overcoming Your Fear of Asking For Help).

How Does Trauma Therapy Work?

Trauma therapy helps clients to process unresolved trauma (see my article: How Does Trauma Therapy Work?).

There are different types of trauma therapy including (but not limited to):

• EMDR Therapy (Eye Movement Desensitization and Reprocessing): How Does EMDR Therapy Work?

• AEDP (Accelerated Experiential Dynamic Therapy): What is AEDP?

• Parts Work Therapy (Ego States Therapy and Internal Family Systems [IFS]): What is Parts Work Therapy?

• Somatic Experiencing: The Benefits of Somatic Experiencing to Overcome Trauma

• Hypnotherapy (also known as Clinical Hypnosis): What is Clinical Hypnosis?

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT (for couples), Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

As a trauma therapist, I have helped many clients to overcome their history of trauma so they can live more fulfilling lives.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

Estrangements Between Parents and Adult Children

In my prior article, How Can Trauma Therapy Help to Cope With Family Estrangements?, I began a discussion about family estrangements and how trauma therapy can help.

Family estrangements, also known as cutoffs, can occur between parents and adult children or between adult siblings (see my article: Healing Mother-Daughter Relationships).

Estrangements Between Parents and Adult Children

In the current article, which is a part of a series of articles on family estrangements, I'm focusing on estrangements between parents and adult children where the adult child has a problem with a parent's current behavior or past behavior.

In this article, I'll use the terms estrangement and cutoffs interchangeably.

What Are the Most Common Causes of Estrangement Between Parents and Adult Children?

Estrangements can occur for many reasons including but not limited to:

• Abuse, including a history of childhood emotional and physical abuse and sexual abuse

• Neglect, including a history of childhood emotional neglect

• Betrayal

• Bullying

• Psychological problems

• Substance misuse and other compulsive or addictive behavior

• Lack of emotional support

• An adult child's or parent's sexual orientation (see my articles: Coming Out as Lesbian, Gay, Bisexual, Transgender or Queer, Coming Out to Your Father as a Gay Man)

• An adult child's or parent's gender identity (see my article: Being the "Different One" in Your Family)

• Choice of a partner or spouse (see my article: What to Do If Your Partner and Parents Don't Get Along)

• Religious views (see my article: Religion: Are You Contemplating Your Faith of Origin in a New Light?)

• Political views

• Money issues, including money borrowed, wills, inheritance plans and so on

• Other reasons

How Common Are Estrangements Between Parents and Adult Children?

It's estimated that approximately 12% of parents and adult children are estranged.

Estrangements Between Parents and Adult Children

Most of the time cutoffs are initiated by adult children.  About 5-6% are initiated by parents.

How Long Do Estrangements Between Parents and Adult Children Last?

The length of time for estrangements varies based on the people involved, the problems between them and other individual issues between parents and adult children.

On average, estrangements between parents and adult children last about nine years. However, an estrangement can be days, weeks or months long.

Can an Estrangement Based on a History of Childhood Abuse Be Reconciled?

The best possible hope for a reconciliation is for a parent to acknowledge and make amends to an adult child.  

The problem is that parents who engaged in childhood abuse often don't admit any wrongdoing. 

Even if they admit that their behavior was abusive, they might try to minimize it by saying their behavior wasn't that bad. 

They might also try to minimize it by trying to deny how the early abuse affects the adult child now by saying something like, "That happened so long ago. Why don't you just get over it?" (see my article: How a History of Unresolved Childhood Trauma Can Affect How You Feel About Yourself as an Adult).

Needless to say, it's hurtful for an adult child, who was abused by a parent, to hear their parent dismiss or minimize the impact of the abuse. 

Under these circumstances, some adult children might feel confused and doubt their early experiences or whether they have a right to ask their parent to take responsibility and make amends.

When a parent isn't ready to take responsibility and make amends, they place a nearly impossible barrier for reconciliation. 

Even if the adult child decides to try to somehow put aside their hurt, they will probably still feel resentment and sadness, which might only allow them to engage in limited contact with their parent.

Even if a parent takes responsibility and shows genuine remorse for their behavior, a reconciliation isn't automatic. Emotional healing is a process and, depending upon the problem and the people involved, a reconciliation might be slow or nearly impossible.

Next Article:

In my next article I'll continue to focus on family estrangements and some suggestions on how to reconcile these cutoffs:

Family Estrangements: Understanding Barriers to Reconciliation

Getting Help in Therapy

Family estrangements are usually emotionally wrenching and traumatic whether you're the person who initiated the cutoff or you're the person who has been cutoff.

Getting Help in Therapy

Trauma therapy can help you to heal.

Rather than struggling on your own, seek help from a licensed mental health professional who can help you to start the healing process.

About Me

I am a licensed New York City psychotherapist, hypnotherapist, EMDR, AEDP, EFT, Somatic Experiencing and Sex Therapist.

I work with individual adults and couples.

One of my specialities, as a trauma therapist, is helping adult clients to heal (see my article: What is a Trauma Therapst?).

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.

 

Overcoming Problems With Anxiety-Related Erectile Dysfunction (ED)

Anxiety-related erectile dysfunction is a common problem for men regardless of sexual orientation, age or race (see my article: What is Sexual Anxiety?).

What is the Link Between Anxiety and Erectile Dysfunction?

Most men experience occasional problems with maintaining an erection and most of the time these occasional problems aren't a cause for concern.

Anxiety-Related Problems With ED

Occasional problems can be related to not getting enough sleep, drinking too much or other factors.

Occasional problems are different from ongoing problems with erectile dysfunction.  

Assuming medical problems have been ruled out by a urologist or a sexual health doctor, erectile dysfunction (ED) is often caused by stress and anxiety, especially when men worry about their ability to please their partner (see my article: The 5 Most Common Male Sexual Insecurities).

Anxiety and stress-related ED can include one or more of the following problems:

• Problems with Body Image: For many men body image problems involve worrying that their penis is too small.  There can be a lot of variation in penis size, however, the average size of a flaccid penis is 3.5 inches and 5.1 inches for an erect penis.  Men who compare the size of their penis to male actors in pornography can develop a distorted view of what an average penis looks like, especially if they don't realize that male actors in porn are chosen for their unusually large penises.  

• Shame and Guilt About Sex: Shame and guilt can be related to many factors, including personal shame about sex, cultural shame or interpersonal issues with a partner.

Anxiety-Related Problems With ED

• Relationship Conflict: Stress and anxiety related to relationship conflict can be a contributing factor to ED and an inability to experience sexual pleasure. Relationship conflict can include frequent arguments, a history of emotional and/or sexual infidelity, financial infidelity, child-rearing disagreements, problems with one's own family or with in-laws, and so on.

• Unresolved Sexual Trauma: When there is unresolved sexual trauma, partnered sex can trigger trauma-related guilt and shame which often has nothing to do with the current sexual partner.  Trauma-related triggers occur in an instant without a person's conscious awareness.  Since trauma-related triggers often occur outside a person's awareness, a man might not understand why he feels so emotionally overwhelmed in the moment because he doesn't realize he is triggered and that the trigger has nothing to do with his current partner.  Anything can act as a trigger including a scent, a word, a gesture, a movement, a particular sexual position and hundreds of other things that were related to the original trauma (see my article: How Unresolved Trauma Can Affect Your Relationship and Overcoming a History of Sexual Abuse).

• Sexual Libido Differences in a Relationship: This is the #1 problem that brings couples into sex therapy.  Even though they can accept that they have differences when it comes to food or entertainment, most people find it difficult to accept that they experience sexual libido differences with their partner. This can create sexual pressure for a man or feelings of sexual rejection which, in turn, can lead to ED or sexual avoidance (see my article: Relationships and Mismatched Sex Drives: What is Discrepant Sexual Desire?).

• Lack of Sexual Experience: When a man worries he won't be able to "perform" sexually or that he won't be able to satisfy his partner, this can lead to "spectatoring" where a man becomes so self conscious that he becomes a so-called "spectator." Rather that enjoying sex with his partner, he is  "spectatoring" which takes him out of the sexual experience and can create a problem ED (see my article: What is Performative Sex?).

• Stress and Worry Unrelated to Sex: A little stress in the form of sexual anticipation can enhance sexual pleasure, but too much stress can lead to ED.  

• Other Mental Health Problems: Generalized anxiety, depression and other mental health problems that are not directly related to sex can also contribute to ED.

How Does Sex Therapy Help Men to Overcome Erectile Dysfunction?

Sex therapy is a form of talk therapy for individual adults and couples (see my article: What is Sex Therapy?)

Sex therapy is an effective treatment for sexual anxiety and other sexual problems.

During a sex therapy session, there is no sex, nudity or physical exams (see my article: What Are Common Misconceptions About Sex Therapy?).

Individuals and couples seek help in sex therapy for many reasons (see my article: What Are Common Issues Discussed in Sex Therapy?).

Regardless of the sexual problem, sex therapy usually begins with an assessment, including taking a family history, relationship history and sexual history to determine how the current problem might be related to the client's history.  This usually takes several sessions.

Sex therapy is an effective form of treatment for ED and other sexual problems (see my article: How Sex Therapy Can Help With Sexual Anxiety).

The underlying issues of erectile dysfunction are different for each person, so there is no one-size-fits all approach to overcoming ED.  

If a man is able to maintain an erection when he masturbates and if he experiences normal erections during sleep and upon waking up (also known as "morning wood"), ED is usually related to an underlying issue that he might have no awareness about before beginning sex therapy.

A sex therapist is a trained mental health professional who has special training in sexual-related problems, including erectile dysfunction.

Sex therapists give sex therapy clients assignments to do at home either alone or with a partner.  This can include (but is not limited to):

• Practicing Sensate Focus or other forms of touch exercises (see my article: What is Sensate Focus?)

• Reading assignments 

• Keeping a journal related to the sexual problem (see my article: Keeping an Erotic Journal)

• Practicing sexual communication with a partner (see my article: How to Talk to Your Partner About Sex)

• Other assignments between sex therapy sessions

If the ED occurs within the context of a relationship, it's considered a relationship problem and sex therapy is more effective if both partners are attending sex therapy sessions together.

In future articles, I'll explore, among other topics, how the penis is often a barometer of physical, emotional and sexual health.

Also, see my article: Is It True That "Real Men" Are Always Ready to Get It Up?

Getting Help in Sex Therapy

In addition to whatever underlying issues there might be, men often feel too ashamed to seek help in sex therapy.  This is often due to distorted stereotypes of what it means to "be a man" or to "be strong."

Getting Help in Sex Therapy

Sexual shame is often reduced or eliminated when men learn how common erectile dysfunction is for men regardless of age, sexual orientation, race and other identifying factors.

If you're experiencing ED, rather than struggling on your own or ignoring the problem, seek help from a licensed mental health professional who is a trained sex therapist.

Getting Help in Sex Therapy

Overcoming anxiety-related ED can lead to more satisfying sex and a more meaningful life.

About Me

I am a licensed psychotherapist, sex therapist, couples therapist, hypnotherapist and trauma therapist (EMDR, AEDP, Somatic Experiencing and other forms of trauma therapy) with more than 20 years of experience.

I work with individual adults and couples and I have helped many clients to overcome sexual problems.

My office is conveniently located in Greenwich Village, Manhattan where I provide in-person and virtual sessions.

To find out more about me, visit my website: Josephine Ferraro, LCSW - NYC Psychotherapist.

To set up a consultation, call me at (917) 742-2624 during business hours or email me.